May 3, 2013

When is it time to give up the keys?


Dear Bloggers,

This blogs subject is about driving and Parkinson's Disease

As baby boomers age and life expectancy rises, increasing attention is turning on how to determine when and if older people and people with severe health problems should stop driving. This topic is especially important in light of a agtng group in our country as a lot of them are on the search for injury prevention and we should get in control that our elderly people are involved by vehicle injuries. As the number one cause of injury related deaths for people aged 65 to 74, and the number two cause (after falls) of injury

related deaths for those aged 75 to 84. The issue that hits home for people with Parkinson's since both the symptoms of the disease and the medications designed to ease them can affect driving ability. If you are struggling with the decision of whether or not to stop driving, or if you are a caregiver for someone who is wrestling with this problem, this blog may help you explore your options.
 
 
How does Parkinson's disease affect driving?

People with Parkinson's disease may eventually experience a decline in both motor skills and cognition. These problems can make driving unsafe. For example, a decrease in visuospatial skill. Let me explain:This is the kind of skills that are necessary to determine distance and distinguish shapes which is not uncommon in Parkinson’s Disease. A driver with decreased visuospatial skills may be unable to gauge the distance to a stop sign or a traffic light or keep a car in the correct lane. Some people with Parkinson's also may have cognitive difficulties and at times become confused. 


Unfortunately, patients with dementia may not realize that their driving has become a problem and must rely on a physician, family members and friends to bring it to their attention. Another common symptomatic problem for people with Parkinson's is muscle tightness, which can make reacting quickly difficult. Delayed reaction time is dangerous because drivers need to be able to react swiftly, both mentally and physically, to avoid accidents and adapt to changing traffic patterns.

Additional complications come from the medications that are used to treat Parkinson’s Disease. Common medications including carbidopa/levodopa (Sinemet), amantadine, dopamine agonists and anticholinergics may produce side-effects such as sleepiness, dizziness, blurred vision and confusion. Anticholinergics are especially dangerous as they can cause confusion and sedation along with memory impairment. However, not every patient experiences these side-effects and they may be decreased with simple adjustments in dosage. You should note any changes and report these to your physician. It is your life and you decide.


 Assessment options for people with Parkinson's

It is important to remember that while not every person with Parkinson's experiences problems with driving, disease symptoms and treatments can make driving dangerous for you and others. Driving is seen as a priveliged right of independence and freedom and you may be reluctant to stop, but being responsible is also important. To help you determine your driving risk, the medical association advice is to report your Parkinson’s at CBR (the Dutch bureau for driving licences) Especially for older drivers with difficulties in traffic and they can give extensive information about diseases that may affect driving ability, such as Parkinson's. Although these guidelines were developed primarily for doctors, it will help laypersons to make their own assessment of their driving ability and determine a course of action.





The question is: “Am I a Safe Driver?” If you just take a driving lesson just to help you evaluate your driving. If you score poorly on this and you are still reluctant to stop driving, refer to the driving school to get some tips for safe drving and really consider speaking with a doctor about the issue. The doctor can run some tests on cognition, mobility, reaction time and visual ability for physicians to perform on patients to determine if a person is driving safely. Yes you might not only kill yourself but also someone else!

A less costly, although less thorough, option is to enroll in a driver safety class, such as the driving  schools are offering to elderly people. While these classes are not specifically tailored for people with Parkinson's, they can provide helpful tips for safe driving. An instructor will lead the class through various ways of enhancing driving skills and safety but often will not make individual assessments.
Finally, you can always visit the CBR and ask to take a driving test. Of course, if you were to fail the test, your license would be revoked.


What can family members and friends do to help?

Understandably, most people are reluctant to give up the opportunity to drive. Because of this, it is often up to family members and caregivers to spot a problem first. If you are a family member or caregiver for a person with Parkinson's and you think it may be time for them to stop driving, remember that this is a very sensitive issue and you must help the person see that his or her driving has become dangerous. Before bringing up the subject, look at the possibilities how to help this older driver, being prepared as they have a million excuses to keep their freedom which is extremely relevant for Parkinson's patients. This can help you determine if your concerns are valid and how you might address them.


Another way to help your loved one with this decision is by stressing that giving up driving does not mean giving up mobility. Your support is crucial in helping a person with Parkinson's admit that his or her skills have decreased without feeling stripped of power. To help people with Parkinson's with their decision to stop driving, provide them with transportation alternatives. The Getting by Without Driving tip is to highlight all other possible modes of transportation, including a partner that is still able to drive, taxis, buses, subways and getting a ride from family members. Some cities also provide travel assistance for people unable to use public transportation. (We got something that is called the Plusbus.) If you know someone with Parkinson's who has had to give up driving, provide him or her with bus routes, taxicab phone numbers, and offer to give rides. For more transportation alternatives, check on the internet for options in your region.This may help a person with Parkinson's to adjust and realize that stopping driving does not mean losing independence.


What's the bottom line?

Having Parkinson's does not necessarily result in giving up driving. However, whether you are a person with Parkinson's or a loved one, it is important to be responsible and remember the potential dangers that Parkinson's presents to driving. Ignoring the effects of the disease and its medications on driving will only create a more dangerous environment for you and other drivers. The best way to be a responsible driver is by paying attention to your driving skills and reporting any changes to your physician. If you have concerns, don't avoid voicing them out of fear of losing your license. Doctors and family members are often happy to help you exhaust rehabilitation options before asking you to give up driving. If it does come to the point where family, doctors and driving coaches ask you to give up your keys, realize that it is in your best interest to stop driving and explore other transportation options. They love you and don’t want to loose you.

The Old Sailor,
 

April 27, 2013

What if you start hating your job?


Dear Bloggers,

Someone I know is having a hard time at the moment as the atmosphere on the workfloor has become less human and more stressful as the chefs only think in digits. This is creating a lot of stress among the co workers as well and slowly she starts hating her job.



I was taught as a young boy to never to use the word “hate”. As there are many other words to choose from. You probably don’t use this word in your house very much either (I hope).

I agree it’s far too strong a word to use when it comes to describing the opposing football team or even a workplace bully.But the reality was for the longest time…


She hates her job, and is afraid to admit it.

If she admits it, would that mean that she’d been wasting her time with all of the energy and hours she has invested in this company?
This question had me concerned, and I discovered that if you hate your job you’re going to burnout.



It’s not a matter of “if”, but “when”.

Also if you hate your job, you’re not fooling anyone. It’s obvious. Hating your job shows up in how you walk into the office, how you answer the phone, and how you participate in meetings.

The easiest way to tell if you hate your job is that it shows up in your language. I had to find some facts about how people think about this issue.



In fact 183 people actually said that on Twitter on Monday before 7 am (I did a Twitter search on “I hate my job”).

Scary, huh?

Most of us don’t actually say it because it feels really uncomfortable.If we’re not actually saying those words it can still show up in more subtle ways like:
  • You avoid telling people what you do for a living.
  • You never share how your work day went with your family.
  • You’ve got worries of impending work doom spinning through your head on Sunday night (dreading Monday mornings).
You can also see it coming if you frequently catch yourself saying, “another day, another dollar” or “I’ve got to go the work today” (instead of “I get to go to work today”).


When you hate your job, you’ll find lots of varied emotions…Each one of the emotions has their own story.
In this case, emotions are predispositions for action.Your emotion comes first and that inspires the action. Imagine if you’re showing up at the office in emotions of resentment, anger, and resignation when you enter the office doors?

The Physical Impact of Hating your Job

When you hate your job it takes a physical toll.The body tension generated from hating your job can lead to all kinds of health related issues. The one that I experienced was an overall tightness at work that started showing up at home and even at being on the push bike.

When you show up this way every day it starts to have a cumulative effect. You can even feel your body cringe when you walk in the door. After awhile you may be slumped at your desk and start finding your muscles tightening especially in your shoulders, hamstrings and lower back. And this is also draining your energy, it makes you extremely tired.
If you’re stuck in this body shape all the time it can tough consequences. This can lead to your body being into a permanent uncomfortable shape of leaning with shoulders forward, a slight bend at the waste, and head down. First of all you need to try to find a way to stop hating your job and if this is not working go find the energy to get an other job.


How do you stop hating your job

The good news is that you can try to stop the job hating and transform your job into one you love. I like to recommend stopping a few things first because that seems to take less energy (versus starting something new).

Here are a few things you can stop doing now to stop hating your job.


Looking Busy

Speak up if you not using your capacity.  The trap can be to get into a job where you using 10% of your capabilities. Often times the corporate environments silently encourages employees to get into a position where they are an expert and know how to do their job.  That’s nice, but sometimes it’s too comfortable and you lose your hunger for creativity and innovation.  You get bored.  You lose your edge.  If you’re using what you can really bring to the table then let someone know and start considering adding something your interested in to your plate.



Hanging around with Co-workers (at least the gripers)
If everyone was complaining about their job at the last happy hour you attended, then stop going with them.  Begin seeking out those people who love their job and go get coffee with them. This has an amazing impact because just as griping is infectious, so is passion!

Bonus Tip *Answer yourself the question “Why?” – Why are you working?  This is the supercharger for all careers. When you connect with the “why” you’re career will take off. You’ll find energy in places you never knew, you’ll wake-up early, and maybe even be disappointed that the work day ends!

The Old Sailor,

April 14, 2013

I recovered from a burn out


Dear Bloggers,

It may be too late for you to talk about avoiding burnout. Maybe you've already reached the stage where you are thoroughly disillusioned with your job and where you no longer get anything of emotional value from it. You may feel let down or betrayed by your organization, and may be "going through the motions" just for the money your job brings in.



While you can deal with exhaustion by taking a good break, rest may not cure this sense of disillusionment. The passion and commitment that you previously brought to your job may now have completely burned out. Without this, your career may not progress much further.
People deal with this situation in a number of different ways. Some are effective, while others are not so good:


 
First of all most of us start with doing nothing: Often, one of the worst ways of dealing with burnout is to accept it and do nothing about it. By remaining in place, you risk becoming bitter and angry as opportunities pass you by. Your organization may come to regard you as “dead wood” and if things do not change, you may be doomed to a gradual or sudden decline. You need to change the situation in some way. 


A better option is changing your career: If you have lost all interest in the values that led you into your profession in the first place, then career change may be the best option open to you. If possible even in total different job and another company.


The first downside of this, however, is that you lose the benefit of the precious experience you have already gained within the profession. In entering a new profession, you will be competing equally with people much younger than you, and these people are willing to accept much lower salaries. I speak about my own experience.

A second downside is that you risk a strong sense of failure in the way how you handled things, whereas burnout will only have been a temporary setback if you succeed in turning the situation around. 


Changing jobs: Job change within the same profession is usually less of an issue than a full-scale career change, in that many of your skills and much of your experience will be transferrable. Job change gives you the opportunity to rededicate yourself to your original goals. It also provides a fresh start in a new environment, without the painful reminders that come with staying in the same job. 



Changing jobs is an appropriate response where you are disillusioned with your organization more than you are with your career. What you risk, however, is ending up in the same situation again: In changing your job, you must make sure that you understand what lead you to burn out, and ensure that history does not repeat itself. Looking at this positively, you should know what to look for, and have a good idea of how to avoid it!
Using your burnout as a trigger for personal growth: This is probably one the most positive ways that people manage burnout: By using it as a wakeup call to re-evaluate the way they want to live their lives and what they want to achieve. 

 

Understanding why you burned out
An important first step in managing burnout is to deal with the sense of failure that you may experience following it. A starting point for this is to take a long, rational, dispassionate look at the circumstances leading up to it.




A good way of doing this is by talking to someone who you trust and who is experienced in similar situations in similar organizations (you may find a personal coach helpful here). Avoid people within your own organization, as these people will be tainted with its assumptions and thinking habits: These may contribute to the problem. Take the time to talk the situation through in detail, looking at the circumstances before your involvement, your workload, your actions and the actions of other people, and the situations that evolved.


If you are the sort of person who has been committed enough to your work to burn out, it is more than likely that you will have already done everything in your power to resolve the situation.
In reflecting, you will probably find that you made some mistakes, but you will most likely see that these are excusable under the circumstances. You will almost certainly see that a great deal of blame should be attributed externally to the situation, to people around you, or to the people who set up the situation in the first place. In your mind, make sure you place this blame where it fairly belongs.




Lessons that people typically learn through this process are that they are not superhuman, that hard work does not cure all ills, and that major achievements need the commitment and support of other people: In many circumstances, the intense commitment of only one person simply is not enough. They also learn to look at situations with skepticism as they go into them, and to trust their own judgment in spotting and communicating problems early on.

Learn the lessons of your mistakes so that you do not repeat them.
Moving On… Finding a “new” direction
 



Having come to terms with the situation, the next step is to re-evaluate your goals and think about what you want to achieve with your life. I touched on this briefly in a avoiding burnout article; however in recovering from burnout, it is worth doing this in detail together with your coachl.
There are many articles on the mind to guide you through the processes of thinking. About for example what you want to achieve with your life and of reviewing and setting life goals.



Implanting these processes with the increased wisdom and self-understanding you will have gained by understanding why you burned out. Ensure that you give due weight to the relaxation, quality of life issues and social activities that will help to protect you against burnout in the future. Make sure that your goals are set in a balanced manner so that they do not conflict with one-another, and that they are not so challenging that they become a source of excessive stress in their own right.


Next, use SWOT Analysis to more fully understand your current position with respect to these goals. Use it to identify where you need to develop new skills and capabilities, and to understand where you need the help of other people.



Make an action plan for achieving these goals and start work on it. While part of this Action Plan may include changing job or (not very easy in these times), you will be doing this as part of an active plan for the future, not as an escape from one job into another one that is equally bad.
As well as taking these active steps to put your burnout behind you, make sure that you adopt the steps towards a healthy lifestyle we looked at in our defences against stress section. These will help you to avoid exhaustion and long-term stress in the future.


The Old Sailor,

April 5, 2013

When the thrill has left your marriage


Dear Bloggers,

Let me make one thing clear straight away. I am in a relationship for 20 years with the same women. Although the love is still there it is not that sparkling anymore as in the beginning. A lot of couples around me experience the same thing and in several cases this has ended into a divorce. Or what I think is even worse that some of them will start a double life by having a girl- or boyfriend next to their spouse and kids.


I have been wondering about this issue as I don’t understand why these people are doing this, is it pure lust or is it because their love turned into something like hate? Why does this happen? Does it solve your problems or do you get into even more trouble if you try to find back the old spark? If I should believe what they are writing in articles about this. You will not find any men’s magazines about this issue. 


Generally speaking, magazine articles about how to improve your sex life, especially in marriage or a long-term relationship contain the same advice: candles, hot baths and soft music are often invoked. The question is why your partner loses interest in having sex with you.
That may be because these “better sex” stories are a pile of women’s magazines. I don’t know about you, but candles always make me think of church, baths are something my mother made me take, and soft music reminds me of going to the dentist. Definite all of them are turn-offs.


But how do you regain the passion in your relationship when you feel it's slipping away? Is it possible? Or when that train has left the station, is it too late to bring it back?
“A lot of people get to that point and have to decide what to do about it,” at least that is what I think. “Novelty is sexually interesting to most people -- not always to the point that they will act on it, but the idea has a little bit of a thrill to it, for men or women.”


In dealing with  my own marriage and we have been together for a while,more than twenty years. “Sometimes with a long-term partner, a person feels like they know every freckle on that other person’s body.”  The solution may lie in exploring the unfamiliar part though not necessarily.


“For some people, predictability is very exciting,” for example having sex on a Wednesday night for others this does not work at all. “You have to figure out if you’re a ‘surprise’ or ‘predictability’ person. If you’re a surprise person, asking your partner to surprise you is a good first step. If you’re a predictability person, and there is something predictably bad or neutral about your sexual experience, getting some changes in there can be a positive thing.”


Those same darn women’s magazines often offer intimacy as the tonic to save the foundering sex life. You’ve drifted apart, and that is where the logic goes. Take interest in his life, his work, his recreation, even if it’s watching retired athletes. Yelling at each other about which programme should be seen on TV. But there is a fine line between being cared for and being under stress.


“Sometimes too much closeness stifles desire,”  would I say.  We had less trouble in the days when I was sailing: “Separateness is a precondition for connection. When intimacy collapses into fusion, it is not a lack of closeness but too much closeness that impedes desire." Don’t call each other ten times a day and don’t ask each other about every little thing. “These questions turn intimacy into surveillance.” And this is defenitly a killer for your relation.


Sometimes a man’s lack of desire is really about something else. “In those situations there is often something going on that is unexpressed or unknown. Most often, it comes down that lack of attraction stems from anger. Perhaps your anger is misplaced; perhaps you are angry at her because you are not attracted to her. You can get to the source of your anger and beyond in therapy. But getting down to getting down is the relationship equivalent of advanced physics.



“You have to be able to experience conflicting feelings, or difficult feelings,” I would call it  the rapprochement process. “If you are holding yourself back all the time, you don’t have to face what you might be feeling. But if you get close to her in bed and if you get aroused, there might be a lot of conflicting stuff that comes up in your head. You want to be with her, you want to make her happy......but on the other side you are angry with her.” To get past the anger, and on to the fun part, you have to be willing to let down your guard, and let love in.


There’s nothing wrong with candles and baths -- or, for that matter, lingerie and scented oils. Those are all stand-ins for the little signals most couples have. Most couples signals are subtler: being in bed and awake at the same time, reaching out to one another on a weekend morning, making some gesture.


You may pine for the days of spontaneity that you enjoyed when your relationship was young  making love at odd hours, in the least likely places, just because you felt like it. But if you have small children, and both having a career, and the usual laundry list of responsibilities, the chances of you spontaneously hooking up without some planning are about like the chance of your playing in the national soccer team, when you’re over 40. And white. It takes a little doing to have a passion in marriage.



There is nothing wrong with planning to have sex, is there? Thinking about it ahead of time might just get you in the mood, just as thinking about what you’re going to eat before you go to a good restaurant only whets the appetite. And don’t be so sure that you know that woman that you’re with. In her work there might be someone more atractive that is how it goes with long married couples, I have found out that I don’t always know what creates sexual arousal in my long-term partner.


I try and lay out my own idiosyncrasies -- what 'does it' for me or what did it for her when we were younger and at our first dates,” What I try to say is: “There is often a moment of revelation: ‘I always thought you liked that!’ Or, ‘I always thought you hated that!’ And it’s often based on something the other person said 20 years ago when you tried something once. So you closed off one portion of sexual experimentation or behavior because of one errant comment.”

A lot can happen in those intervening years. Isn’t it time you found out what’s going on beneath the surface? 
I did not find all the answers yet.

The Old Sailor,

March 27, 2013

That is my wish...


Dear Bloggers,

Sometimes there are moments in life where shivers run down your spine. This may be of emotion, love, fun moments on television because you're sick, happy or maybe sad or filled with grief. Outside these emotions or feelings, there are many other causes consisting of emotion and chills. When I look up to the sky, I see the beautiful white clouds floating and an airplane flies over with a leaving a beautiful white trail behind on its way towards the sun. Sitting at the computer at home I hear the music on the radio as an emotional tone makes my thoughts play.


Listening to Glennis Grace a great Dutch artist singing “Dat is mijn wens,” translated “That is my wish,”I remember most of the beautiful things in my life. The life which today includes also anxiety, panic, stress and aggression. My mind changed after I fell down the stairs some years ago and I never found the old me back. kicking people to death has become nearly normal in today's society, or shooting people for no reason as well.



It also became normal to insult others or abuse persons in a public job has become one of the most normal things in life. The word "respect" that everyone knows has become totally meaningless. You may try it but it seems to be an impossible task to correct people their behavior. People live in fear of "something might trigger them." And the only way to pay for it is my life. It is scandalous.



 
I think everyone who reads this, has a fun moment in his life and can bring forward something from his or her childhood. Moments from the highest classes of elementry school that you were at camp and you were dating and later saw that she was the cutest or ugliest girl or boy of the class. Children like my daughter Danique, who is dancing to music of K3, slip into the thought that they are playing outside going of the slide, and sleep under a blanket of Winnie the Pooh.


 

Often I wish applicable to the number Glennis Grace, that people could be that child again. Rather than the age, gaming or the leisure. But the variation of thoughts that children have, never have to worry and especially that they are having no real stress or feelings of anxiety or other "common evils". No they rather looking on the bright side of life.



Children are enjoying small things like a cup of tea, a glass of lemonade or a delicious candy. They can enjoy nature, that birds are singing, playing tag or hide and seek behind a thin tree where a parent is actually too thick for it. Nowadays the life about of care and concern. Take care of your immediate family, friends or other very important people in your life. Take care of your family, wife and / or child (ren). 




Of course sometimes it's just not easy, and of course "sometimes" something like that can take years. Life does not go hand in hand with everyday joy, love and romance. Sometimes years go by illness, accident or "it's not today" moment. Sometimes we have to say goodbye to people close to us or someone we should support in his mind as the sun doesn’t shine, but you rather see clouds, and that there are a lot of them that go past you.



Support people, help people or give people the help that they need. As relatives, friends or family grab each other's hand and go happily through this life. When we see children on the news or in the newspapers that carry a gun or tell them while playing tag their brother could be lost because he stepped on a mine, then I'm happy with my wife and daughters, so I doubly enjoy those little things that makes life in the Netherlands not that bad. 



Because what can beat the thought of walking arm in arm on the beach, under a sun that slowly goes down in the North Sea. My daughters running in front of us finding one after the other shell, that looks like a win for their collection! one family, one thought, one feeling to make a desirable family complete. That is my wish...........

The Old Sailor,

When Anger makes life difficult

   Dear Bloggers,   Accidentally I met a new person a nearly sixty-year-old man from Turkey who is already here for more than forty years...